Abstract: Objective To understand the immune advantages of non-tracheal intubation video-assisted thoracoscopic surgery (VATS) by comparing with influence of tracheal intubation for VATS on the humoral immunity. Methods Between January 2015 to May 2017, 118 patients undergoing VATS in our hospital were assigned into two groups according to non-tracheal intubation anesthesia group (group A, n=48) and tracheal intubation anesthesia group (group B, n=70) according to the patient's informed choice. Ten mL of peripheral blood was prepared at 1 day before the surgery, and 1 day, 3 days and 7 days after the surgery for the measurement of IgA, IgG, IgM, CRP, C3 and C4 by using immunoturbidimetric assay. The results between the two groups were compared by using SPSS 18.0 for statistical data processing and statistical analysis. P<0.05 was considered to be statistically significant. Results After the operation, the levels of all the immunoprotein reduced in different degree, except for CRP. There were no significance on IgA, IgG, C3, C4 level between the two groups on D1, D3 and D7 (all P>0.05, t=1.746, 0.899, 1.342, 1.775, 1.440, 1.779, 0.192, 0.633, 0.242, 0.931, 0.996, 0.741, respectively). The level of IgM on D1 and D3 after the surgery in the non-tracheal intubation anesthesia group was significantly higher than that in tracheal intubation anesthesia group (P<0.05, t=2.868, 2.930), however, the level of CRP in the non-tracheal intubation anesthesia group was significantly lower than that tracheal intubation anesthesia group (P<0.05, t=4.952, 3.271). Conclusion When compared with tracheal intubation anesthesia, non-tracheal intubation VATS can decrease the postoperative humoral immune response.